Gastric bypass band and surgical method

ABSTRACT

An inventive method for performing gastric bypass surgery and a gastric bypass band that is used in conjunction with the surgical method is disclosed. The inventive method involves separating a top portion of the stomach along with the esophagus from the remainder of the stomach, and re-connecting the separated portion to the small intestine to form a gastric pouch of about 20-30 cc in size. The inventive gastric band is placed midway along the gastric pouch to act as a restrictor valve to limit the amount of food passing through the valve. The band also retains food within the gastric pouch to give the patient a feeling of satiety. The band is comprised of an expansion-resistant section combined with a one-way latch mechanism. The latch has a curved orientation so that the band is formed into a radial profile when placed around the gastric pouch.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.10/876,397 filed Jun. 24, 2004, now U.S. Pat. No. 7,909,839, whichclaims the benefit of U.S. Provisional Ser. No. 60/574,741 filed on May26, 2004, which applications are fully incorporated herein by reference.

TECHNICAL FIELD

The present invention pertains to devices for performing gastric bypasssurgery for morbidly obese individuals, and more specifically, to agastric bypass band which creates a small gastric pouch from theesophagus and a portion of the proximal stomach. This invention alsodetails the gastric bypass surgery method that is performed inconjunction with the application of the gastric bypass band.

BACKGROUND

In the United States, obesity affects the health of 80 million adults,or 35 percent of the adult population, according to statistics from theCenters for Disease Control and Prevention. American children are alsobecoming increasingly affected by obesity, as 9 million, or 15 percentof the child population has fallen victim to this disease in recentyears.

Morbidly obese individuals are identified as those where the disease ofobesity has advanced to where the individual has a Body Mass Index (BM1)of over 40 or a BMI of over 35 along with other “co-morbidities” such asdiabetes or high blood pressure. To reach a BMI of 35, a 5-foot-10-inchman or a 5-foot-4-inch woman would need to weigh 243 pounds and 204pounds, respectively. For these individuals, dieting has often become afutile effort, as while some pounds may be shed, over time it has beenfound that these pounds are often quickly regained. Due to the healththreats posed by their condition, morbidly obese individuals have turnedto gastric bypass surgery in increasing numbers as an effective methodto lose weight.

There are a number of methods of gastric bypass surgery, as well as anumber of medical appliances which have been developed to assist in theapplication of these methods. However, most methods of gastric bypasssurgery operate on the theme of creating a reduced-size “gastric” pouch”out of the stomach, which remains connected to the small intestine. Thepouch restricts the amount of food entering the body to a fraction ofwhat would normally enter an unrestricted stomach. Once the pouch isfull, the patient often experiences the same feelings of fullness andsatiety as would be experienced with an unrestricted stomach.

U.S. Pat. No. 5,771,903 issued to Jakobsson involves a method of gastricbypass surgery where the lower part of the esophagus is dissected and aband is applied around the lower part of the esophagus and an upper partof the stomach to form a small gastric pouch which upon filling withminimal food gives the patient a feeling of fullness or satiety. Theband is inflatable and serves as a type of restrictor valve to regulatethe amount of food passing from the banded upper gastric pouch to theunrestricted lower stomach. The band can be selectively inflated ordeflated, depending upon the amount of food that is desired to be passedfrom the upper to lower stomach.

U.S. Pat. No. 6,572,627 issued to Gabbay discloses a system to inhibitthe expansion of the stomach. The system involves placing a band aboutmidway along the patient's stomach to create a restricted, smallerstomach. The system also employs a section of webbing that is placedaround the upper half of the now restricted stomach. The webbing helpslimit the expansion of the upper stomach.

Other inflatable band devices include the Lap Band™ System from InamedHealth of Santa Barbara, Calif.; the Heliogast™ gastric band fromHelioscopie of Vienne Cedex, France; the Midband™ from MedicalInnovation Development of Villeurbanne, France; and the SwedishAdjustable Gastric Band (SAGB) from Ethicon Endo-Surgery of the UnitedStates. These devices are placed around the stomach at its top ormidpoint to create a smaller stomach.

The Proring® and Siliband® are gastric bands, both from InnovativeObesity Care of Saint Etienne, France, which require that the top of thestomach and esophagus first be stapled to form a small stomach pouch.The Proring® and Siliband® are then placed at the bottom of the pouch toform a restrictor valve for regulating the passage of food materialsinto the lower stomach. The Proring® has a closeable latch with amale-female engagement which is locked by the placement of a suture. TheSiliband is closed and attached with sutures.

The prior art gastric band devices and their associated medicalprocedures have a success rate of about 65%, with many patientsexperiencing weight gain again after 5 years. Also, the followingcomplications can result from existing devices and procedures.

First, the adjustable band devices can have a cross sectional contactwidth as large as 1″ which has been found to cause the leakage of pouchcontents into the peritoneal cavity, should these devices erode into thegastric pouch. The body is unable to form scar tissue around, and sealoff, such a wide band device. This erosion problem is serious in thatsome deaths have occurred, and in lesser cases, these prior art bandshave had to be removed, or else additional surgeries were necessary torepair leakage problems.

Second, the adjustable band devices have a tendency to accidentallyenlarge, thereby letting more food through the restricted area thandesired, and causing weight gain to return.

Therefore, a need exists for a gastric bypass band which does notpromote leakage of pouch contents into the peritoneal cavity and whichfurther does not accidentally enlarge, thereby allowing weight gain toreturn.

The foregoing reflects the state of the art of which the inventor isaware, and is tendered with a view toward discharging the inventor'sacknowledged duty of candor, which may be pertinent to the patentabilityof the present invention. It is respectfully stipulated, however, thatthe foregoing discussion does not teach or render obvious, singly orwhen considered in combination, the inventor's claimed invention.

SUMMARY OF THE INVENTION

The invention is a method for performing gastric bypass surgery and aninventive gastric bypass band used along with the method.

The method of surgery involves separating the esophagus and a portion ofthe proximal stomach from the top of the remaining major portion of thestomach. The separated portion is used to form a small gastric pouchthat can hold between 20-30 cc (about ⅛ cup) of food material. Theinventive gastric bypass band is then placed in the mid-portion of thepouch to create a valve-like opening which will cause solid foods tostay in the gastric pouch for awhile, to give the sensation of a “fullstomach.” The band also prevents stomal dilation, that is the stoma, oropening between the pouch and small intestine (described further below)is prevented from dilating.

Still in reference to the inventive method, the small intestine isbisected to create a top section and a bottom section. Preferably, thetop section includes the duodenum which retains all of its capability toreceive liver bile, enzymes, and pancreatic secretions. The bottomsection is connected to the bottom of the gastric pouch so that any foodmaterials that pass by the gastric band restriction will empty directlyinto the small intestine for further digestion. The top section is thenconnected to the bottom section of the intestine which allows liver bileand pancreatic secretions from the top section to come into contact withthe partially digested food materials that have been traveling from thegastric pouch down to the bottom section. Liver bile begins fatdigestion for the first time and as a result, fats are only partiallyabsorbed, contributing to greater weight loss.

The majority portion of the stomach comprising the remaining stomach andduodenum is completely separated from the manufactured digestive tractconsisting of the gastric pouch and bottom section of the smallintestine. The majority portion is sewed against the inner body cavitywall of the patient, and a radiopaque marker band is placed between themajority portion and the body cavity wall. A gastrostomy tube is placedthrough the marker band for immediate post operative care and theradiopaque marker band functions as a marker to locate this stomach siteif it becomes necessary to place a gastrostomy tube for decompression orto feed the patient normally through the stomach or else to allow thesurgery to be reversed and the stomach reconnected at a later date. Theinventive gastric bypass band is also radiopaque.

The gastric band device which also comprises the invention is comprisedof an expansion-resistant section that is attached to a latchingmechanism. Preferably, the latching mechanism is of a one-way,male-female design, which comes together from opposite ends of theexpansion-resistant section. When the latch is engaged, the band deviceassumes a radial shape which encircles the gastric pouch at a locationselected by the surgeon. The radial shape and small width of the bandhelps prevent the device from becoming ingrown into the gastric pouchand/or causing tissue necrosis. The radial shape is best achieved if theopposite components of the latch are curved to aid in forming the radialshape upon joining the ends of the latch together.

It has been found that over time, using experimental fore runners of theinventive device and method, when employed together, resulted inpatients maintaining their weight loss in 90% of the cases that arefollowed beyond 5 years post-surgery. This, compared with a success rateof only 65% of weight loss beyond 5 years post-surgery for the prior artgastric bypass surgery methods and banding devices, illustrates a largeadvantage of the inventive device and method.

As such, the following objects and advantages are sought to be achievedby the inventive gastric bypass band device and medical method:

An object of the invention is to provide a gastric bypass surgicalmethod which bypasses the majority of the stomach and duodenum, therebyresulting in less post-surgery expansion of the gastric pouch.

Another object of the invention is to provide a gastric bypass banddevice which is available in multiple sizings to be able to meet anysurgical situation.

Still another object of the invention is to provide a medical method andassociated gastric band device which results in maintaining a 90% weightloss, beyond 5 years post-surgery, in morbidly obese patients.

Another object of the invention is to provide a device that can beeasily placed and removed less invasively, laparoscopically, therebyreducing surgical recovery time to around three weeks.

Further objects and advantages of the invention will be brought out inthe following portions of the specification, wherein the detaileddescription is for the purpose of fully disclosing preferred embodimentsof the invention, without placing limitations thereon.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood by reference to thefollowing drawings which are for illustrative purposes only:

FIG. 1 is a frontal view of a human esophagus, stomach and partial smallintestine to illustrate the body locations near the esophagus and smallintestine where the inventive medical procedure is performed.

FIG. 2 is a frontal view of a human body cavity showing the esophagusconnected to the lower portion of the small intestine and the upperportion of the small intestine, containing the duodenum, being connectedto the lower portion of the small intestine.

FIG. 3 is an elevated perspective view of the inventive gastric bypassband shown in its engaged state.

FIG. 4 is a cross sectional view through the expansion resistant sectionof the inventive gastric bypass band.

FIG. 5A is a closeup elevated perspective view of the female portion ofthe latch.

FIG. 5B is a closeup elevated perspective view of the male portion ofthe latch.

FIG. 5C is a closeup elevated perspective view of the male portion ofthe latch fully engaged within the female portion.

FIG. 6 is a side view of the gastric bypass band device shown in anengaged position, illustrating the radial shape of the device.

FIG. 7A is a side view of a protective cover for engaging with thefemale portion of the gastric bypass band device.

FIG. 7B is a front elevated perspective view of the cover.

FIG. 8 is an elevated perspective view of the radiopaque marker band ofthe present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring to FIGS. 1 and 2, the preferred embodiment of the inventivemedical method can be shown. The medical method is performedlaparoscopically in 90% of the cases. In FIG. 1, the organs of theesophagus 10, stomach 14, duodenum 16, small intestine 18 and gallbladder 20 are shown. The focus of the medical method is upon themodifications made to the esophagus 10, stomach 14 and small intestine18. As first shown in FIG. 1, a gastric pouch is manufactured bypreferably separating the esophagus 10 and part of the lesser curvature22 of the stomach from the remainder of the stomach 14 at point A. Thesmall intestine 18 is bisected at point B. The location of point B ispreferred because it results in the duodenum 16 being completelybypassed along with the stomach 14. Bypassing the duodenum results inselective fat malabsorption which results in more weight loss than inprior art gastric bypass methods. The duodenum remains fully functionaland continues to receive liver bile from the hepatic ducts 24 andenzymes from the pancreatic duct 26.

Referring now to FIG. 2, the formation of the gastric pouch and there-connection of the small intestine can be described. The proximalstomach is bisected on the lesser curvature 22 just below the esophagus10, leaving a small stomach segment 28 that is connected to the proximaljejunum 18, this esophogeal and small stomach segment is what willeventually form the gastric pouch 30 having a size of between 20-30 cc.The bottom section of the small intestine (proximal jejunum) 18 belowthe duodenum 16 is connected to the small stomach segment 28 through ahand sewn closure to form an anastomosis (not shown) that is 1.5 to 2 cmwide. The anastomosis is impervious to air and water and allows directentry of the contents of the gastric pouch 30 into the small intestine18, which causes the release of satiety stimulating chemicals known asenterokinins. This release of enterokinins is even induced by the obeseindividual's salivary secretions that go from the gastric pouch 30 tothe small intestine 18. This feeling of satiety, or “fullness” resultsin anorexia and enhances initial weight loss as well as the maintenanceof weight loss over time.

Above the anastomosis and above the bottom of the pouch 30, about 2 cm,is placed the inventive gastric bypass band device 32. The gastric banddevice acts as a restrictor valve which controls the emptying ofpartially digested food materials from the gastric pouch 30. The gastricband 32 is preferably placed at the distal portion of the gastric pouch30. When the inventive gastric band is in place, the portion of thepouch above the gastric band is 15 to 20 cc in capacity and the portionof the pouch below the band is about 8 to 10 cc in capacity. Thiscompared to the normal 2000-3000 cc capacity of the stomach illustratesthe restriction in food intake provided by the gastric pouch. Once thegastric pouch is full of food materials, a feeling of satiation isexperienced, resulting in anorexia. The gastric band device 32preferably ranges in size between 5.5-7.0 cm in inner circumference. Inaddition to its function as a restrictor valve, the gastric band 32prevents stomach dilation, meaning that the restricted opening providedby the band never expands in size due to the expansion-resistantconstruction of the device. Moreover, the pouch 30 is more resistant toexpansion than the stomach. The relative size of the pouch ensures thatexcessive expansion does not occur. Patients that have been X-rayed fiveyears post-surgery show that the pouch has not expanded by much.Moreover, the small size of the pouch insures that if a patientover-eats, the food will back up into the esophagus, thereby causing thepatient to regurgitate the food. This factor operates as aself-regulating feature, and for this reason, patients are counseled tokeep their food intake to a minimum.

The duodenum 16 is re-joined to the small intestine 18 to form a Y-limb34, with one deviation of the limb going upward to the duodenum and theother deviation proceeding upward to the gastric pouch 30. Theintestine-intestine connection 36 forms an anastomosis (not shown) ofapproximately 2 cm, that is wide enough to allow food to pass througheasily. At the point of anastomosis, pancreatic juices and liver bilefrom the duodenum can now come into contact with the partially digestedfood that travels down the second section of the intestine from thepouch. Liver bile begins fat digestion for the first time, and as aresult, fats are only partially absorbed, thereby helping contribute toweight loss. Sugars are absorbed, but discouraged as part of thepatient's diet, because with the stomach disconnected, they go directlyinto the intestines, causing some patients to have “Dumping Syndrome.”This is a very uncomfortable feeling of cramps, flushing, fast beatingheart, weakness and sometimes watery stools.

The stomach 14, although disconnected, remains fully functional, and ifnecessary can be reactivated by reversing the surgery and re-connectingthe stomach segment 28 and small intestine 18 to their prior, natural,state. The stomach 14 can also be reactivated by placing a temporarygastrostomy tube 38, as shown, through which food can be routed, shouldthis be necessary. To facilitate the reactivation of the stomach 14, thestomach opening 40 can be marked with a radiopaque marker band 42 ordisk, that is sutured to the abdominal wall, thereby making it clearlyvisible to allow the surgeon to find the stomach entry site 40 on anX-ray, to allow easy reactivation.

The inventive gastric bypass band device 32 that was introducedpreviously, as being crucial to the successful result of the inventivesurgical method, will now be described in terms of its preferredembodiment. Referring to FIG. 3, the gastric bypass band 32 is comprisedof an expansion-resistant section 44 mated to a latch 46, which locksupon full engagement, thereby preventing the device 32 from opening upwhile positioned within the body. The latch 46 is of a one-way varietyand can only be released through the application of a specializedsurgical tool (not shown). The expansion-resistant section 44 preventsthe device from expanding too far, thereby restricting the amount offood traveling from the gastric pouch 30 to the small intestine 18. Itis important for the device to retain food within the pouch long enoughfor the patient to feel sated, thereby reducing hunger and preventingfurther eating. The expansion-resistant section 44 is preferably madefrom implant grade silicone rubber surrounding a monofilament core. Themonofilament can be polypropylene suture material, which is resistant toexpansion. The latch is preferably made from surgical-grade plasticssuch as polypropylene or acetal, which gives both strength and lubricityto the latch.

FIG. 4 shows a transverse cross section of the expansion-resistantsection 44 which illustrates the monofilament core 48 surrounded bysilicone material 50. Alternatively, the silicone material can be asilicone tube having a monofilament core therein. Theexpansion-resistant section 44 preferably has a flat-faced inner side 52as shown. This flat face 52 continues longitudinally along the length ofthe expansion-resistant section 44. The flat face 52 forms a flat-sidedinner circumference when the latch of the device is engaged, as shown inFIG. 3. It has been found that the flat face prevents theexpansion-resistant section from migrating into the patient's tissue andprevents tissue erosion. Also crucial with regard to preventing leakagecaused by the device eroding into the internal lumen of the gastricpouch is that the cross-sectional diameter of the expansion-resistantsection 44 is kept to 0.125″, or less. If erosion occurs, it has beenfound that if the cross section is kept to these approximate dimensionsthe pouch tissue will form a scar around the band device 32, and inessence seal off the device, thereby preventing any leakage.

Erosion is caused by tissue necrosis, where tissue dies when the supplyof blood to the area is cut off. Prior art larger, thicker, banddevices, have been known to necrose when the food pouch begins to sag,making a deep sack out of which food has difficulty being passed. Thisfood begins to decay in the pouch, which can lead to necroticcomplications. The larger, thicker, prior art devices penetrate thenecrosed area in time, creating a break in the gastric pouch, which canlead to leakage of the pouch contents into the interior of the bodycavity. In the worst cases this can lead to death; in the minor cases,additional surgery is necessary to repair the breached pouch.Contrastingly, fewer pouch breaches are experienced with the presentinvention than with the prior art devices.

Referring now to FIGS. 5A, 5B and 5C the latch 46 can be examined. Thelatch is preferably a one-way latch employing a one-way male-femaleengagement. The opposite ends 54, 56 of the expansion-resistant section44 are each mated to one-half of the male-female latch as shown in FIG.3 and a preferred method of mating is further described below.

As shown in FIG. 5A, the female portion 58 of the latch 46 isillustrated in detail. The female portion has an exterior body 60 and aninterior lumen 62 for receiving the male portion 64 of the latch. Thelumen 62 is sized to compress the lateral prongs 66 of the male portion64. Under surgical conditions, engagement of the male and femaleportions is performed with a forceps, laparoscopically. The preferredinterior lumen 62 dimensions are approximatelyheight=0.082″×width=0.190×length=0.300″. A pair of openings 68 areplaced in each side 70 of the female portion 58 to allow for theexpansion of the lateral catches 72 of the male portion 64. The lateralcatches 72 engage fully and laterally within the side openings 68, in aone-way fashion. Side openings 68 have top, bottom, rear and frontwalls, which engage catches 72. The engagement is such that the latchcan be released only after applying a special surgical tool (not shown)to disengage the latch 46, by placing inward force upon catches 72through side openings 68. The lumen 62 opens outward and the face 74 ofthe opening of the lumen is inwardly beveled so as to receive theoutward bevels 76 of the male portion 64. The corner facings 78 of thefemale portion 58 are rounded so as to present a non-irritating surfaceto the patient.

Still referring to FIG. 5A, the body 60 of the female portion 58 islongitudinally curved 80. The curvature of the female portion 58 mateswith the longitudinally curved male portion 64 to form the device 32into a radial shape as shown in FIG. 6. This radial shape is crucial forpreventing the device from becoming ingrown within a patient's tissue,as this shape applies equal pressure to the enclosed tissue at everypoint along the inside circumference of the device 32. Shapes that arenon-circular (e.g. oblong shapes) tend to apply unequal pressure alongtheir inside circumference, thereby resulting in a cutoff of bloodsupply, necrosis, and eventual tissue erosion and leakage as discussedpreviously. For each graduation in inner circumference of the inventivedevice 32, a corresponding radius of curvature applies which contributesto the forming of the proper radial shape in each case. The radii ofcurvature in inches is listed after each graduation in innercircumference (centimeters) as follows: 5.5 cm=5.5 cm=0.398″; 6.0cm=0.422″; 6.5 cm=0.460″ and 7.0 cm=0.492″. Also, for the samegraduations, the following diameters apply: 5.5 cm=1.75 cm dia; 6.0cm=1.91 cm dia; 6.5 cm=2.07 cm dia; 7.0 cm=2.23 cm dia. The innercircumference that is used is open to the discretion of the surgeon, butgenerally, men require 6.5 and 7.0 cm sizes while women require 5.5 and6.0 cm devices.

Referring now to FIG. 5B, the male portion of the latch is shown ascomprising a pair of lateral prongs 66, the prongs being longitudinallycurved to mate efficiently within the lumen 62 of the female portion 58.Preferably, prongs 66 are approximately 0.076″ thick, by 0.040″ wide.The prongs terminate at their front with lateral catches 72 which aremolded integrally with the prongs 66. Lateral catches 72 are angledlongitudinally along their side face 84, the angled attitude allowingeasy entry of the prongs 66 into the lumen 62 of the female portion 58,which is an important feature under surgical conditions. Side faces 84having steeper angles give a mechanical advantage when locking. Thepreferred angle of side faces is 36 degrees or less. The catches 72further comprise lateral catch faces 86, which engage the front walls ofthe side openings 68 of the female portion 58. When the catches 72 ofprongs engage, it is preferred that they remain engaged under a pullingstress of at least 5 pounds of force. The prongs 66 are separated byinner space 88, which allows the prongs to travel inward and outward.The prongs 66 terminate rearwardly at prong body 90, which provides abase of structural integrity from which prongs can confidently travelinward and outward as they engage the interior walls of lumen. Prongbody 90 migrates further rearward to become outwardly beveled face 76which mates with inwardly beveled face 74 of the female portion 58. Thebeveled face 76 migrates further rearward to become hilt 92. Hilt 92 iswhere the front opening of the female portion 58 fully engages against.This engagement is shown in FIG. 5C which illustrates lateral catches 72seated in the side openings 68 of female portion 58, the hilt being 92engaged with the front opening of female portion. The circumference ofthe body 60 of female portion 58 and the circumference of the hilt 92 ofthe male portion 64 are preferably identical so as to provide a fairlyuninterrupted surface traveling from one to the other.

Also shown in FIGS. 5A and 5B are anchor arms 94, which are used toattach the male and female portions of latch to the expansion-resistantsection 44. Anchor arms 94 retain the curved theme of the male andfemale portions, 58, 64 of the latch 46. Anchor arms 94 are moldedintegrally with their corresponding latch portion and curve rearwardlyso as to retain the radii of curvature of the inventive device notedpreviously. The expansion-resistant section which is comprised ofsurgical grade silicone and monofilament is attached to the anchor armsas follows. Referring again to FIG. 5B, the front opening 96 of lumen 98is shown, and its rearward path of travel through anchor arm is shown inphantom. A similar arrangement exists for female portion. Monofilament48 enters the rear of anchor arm and is fed through lumen until itprotrudes through the front opening of lumen. The monofilament 48 isthen tied off in a manner so as to anchor it in place along with thesilicone material as seen in phantom, in FIG. 3.

As FIGS. 7A-7B show, the body 60 of female portion 58 may also be fittedwith a disposable cover 100 so as to reduce its potential to snag upontissue as it is being fed through and positioned around the gastricpouch 30 during laparoscopic surgery. As the device is fed through thetissue and around the new pouch, it is led by the female portion 58.Cover 100 provides a streamlined shape which can be grasped by a forcepsand easily led through the tissue. FIG. 7A is a side view showing thefemale end 58 positioned in the cover 100, with the remainder of thedevice trailing out the back end 102 of cover 100. Back end 102 of coverincludes a lumen (see FIG. 7B) 104 for receiving female end 58, thelumen being sized to snugly grasp female end without coming loose duringsurgical placement. The sides of lumen are preferably ringed with smallridges 106 to reduce the frictional engagement between female portion 58and the cover 100 to a level that allows easy removal of the cover oncethe device is in place. As seen in FIG. 7B, cover 100 further comprisesa blunt front end 108 which extends into an elongate portion 110. Theblunt front end 108 facilitates easy movement through tissue. Theelongate portion 110 is for grasping by the surgeon's forceps to allowthe cover to be threaded through tissue. Past the elongate portion 110,the cover 100 has a gently tapered region 112, which, again contributesto easy movement through tissue. At its widest point, the cover is about0.250 to allow easy movement through a trocar during laparoscopicsurgery. The cover is preferably made from a radiopaque material foreasy sighting on an X-ray. The cover is removed and discarded once thedevice has been positioned around the gastric pouch.

Referring now to FIG. 8, the radiopaque marker band 42 previously shownin FIG. 2 can be more precisely described. The band's inside diameter isapproximately 0.8″ and the outside diameter is approximately 1″ with athickness of approximately 0.06″. The band is preferably flat along itsmajor surfaces 114, 116. The marker band 42 can be made from polyestermesh that is coated with surgical grade silicone. Also, it is envisionedby the inventor that the inventive device 32 can be combined with theradiopaque marker band 42 shown in FIG. 8, as well as with thedisposable cover 100 to form a surgical kit. This kit can then beinstalled surgically using the method previously described.

Finally, although the description above contains many specificities,these should not be construed as limiting the scope of the invention butas merely providing illustrations of some of the presently preferredembodiments of this invention. Other modifications by those skilled inthis art are possible and are included within the scope of the appendedclaims.

The invention claimed is:
 1. A surgical band device that islaparoscopically implantable within a patient's body, comprising: aflexible expansion-resistant section having first and second ends, theexpansion-resistant section having a flat face extending along itslength between the first and second ends, the expansion-resistantsection being of uniform-cross section between the first and secondends; and a lockable latch having first and second latch parts coupledto the first and second ends of the expansion-resistant section; whereinthe first and second latch parts have a fixed longitudinal curvaturewhen the first and second latch parts are unlocked; and wherein theexpansion-resistant section having a longitudinally extendingconfiguration along its length when the first and second latch parts areunlocked and the surgical band device is fed laparoscopically throughtissue within the patient's body and a radial shape configuration alongits length when the first and second latch parts are locked and thesurgical band device is positioned around tissue within the patient'sbody; wherein the first latch part of the lockable latch including anexterior body having an interior lumen, said exterior body having sidethrough-openings communicating with said lumen, said lumen including afront opening, wherein said front opening is lined with aninwardly-beveled face; wherein the first and second latch parts of saidlockable latch are engaged by a male-female type engagement; wherein thesecond latch part of the lockable latch including two lateral prongsextending from a prong body, said prong body having an outwardly-beveledface, said lateral prongs extending forward of said prong body andending in two corresponding lateral catches, said lateral catchesincluding angled side faces for engaging with said lumen of said firstlatch part, said lateral catches further engaging in a lockable one-wayengagement with said side openings of said first latch part when saidfirst and second latch parts are fully engaged and wherein upon fullengagement, said outwardly-beveled face of said second latch part mateswith said inwardly beveled face of said first latch part.
 2. The banddevice as recited in claim 1, wherein the expansion-resistant sectioncomprises a length of silicone having a monofilament core.
 3. The banddevice as recited in claim 2, wherein the monofilament core is apolypropylene suture.
 4. The band device as recited in claim 3, whereinthe device is radiopaque.
 5. The band device as recited in claim 1,wherein the latch locks in a one-way engagement.
 6. A surgical kit,comprising: a gastric bypass band device that is laparoscopicallyimplantable within a patient's body, comprising: a flexibleexpansion-resistant section having first and second ends, theexpansion-resistant section having a flat face extending along itslength between the first and second ends, the expansion-resistantsection being of uniform-cross section between the first and secondends; and a lockable latch having first and second latch parts coupledto the first and second ends of the expansion-resistant section; whereinthe first and second latch parts have a fixed longitudinal curvaturewhen the first and second latch parts are unlocked; and wherein theexpansion-resistant section having a longitudinally extendingconfiguration along its length when the first and second latch parts areunlocked and the surgical band device is fed laparoscopically throughtissue within the patient's body and a radial shape configuration alongits length when the first and second latch parts are locked and thesurgical band device is positioned around tissue within the patient'sbody; a radiopaque marker band; and a disposable positioner cover fittedover the second latch part and having a blunt forward profile forguiding the gastric band device into position about tissue in apatient's body.
 7. The surgical kit as recited in claim 6, wherein theband device, and the disposable cover are radiopaque.
 8. The surgicalkit as recited in claim 6, wherein the positioner cover furthercomprises a lumen for receiving the second latch part, the lumen of thepositioner cover being lined with longitudinal ridges.
 9. The cover asrecited in claim 8, wherein the lumen forms a rear opening in thepositioner cover, the lumen portion extending forward and mating with anelongate portion of the positioner cover, the elongate portionterminating in a blunt forward end.